Throughout transition, one question has stood out for me above the others: is this the right thing to do? For good reason, of course: any transsexual person, as well as the attendant medical personnel and friends, family and colleagues, understands the surgical conclusion to the pathway to be irrevocable.

A 'real life experience' of living in one's desired gender for a minimum period as a means of determining suitability for medical intervention is recommended, but not mandated, by the World Professional Association for Transgender Health (WPATH) organisation's Standards of Care. The NHS makes this central to their protocol, with gender identity clinics (GICs) demanding at least three months prior to hormone prescription, and two years before sex confirmation surgery. These lengthy periods (often exaggerated by the waiting lists) aim to ensure that nobody undergoes treatment that s/he will later regret.

Since the early 50s, when Roberta Cowell and Christine Jorgensen hit the headlines, media coverage of gender variance has focused on transsexual people, emphasising (if not sensationalising) the medical aspects of transition. The social implications of coming out as transsexual (or otherwise transgender) have received far less attention, but the question of possible regret is just as pertinent at this point as at any other: telling people that you want to transition is as difficult to reverse as any of the consequent physical interventions.

Close friends posed this question as soon as I came out to them, although they appreciated that I would not have made such an announcement without giving it serious consideration beforehand. We also knew that the medical services would ask this more pressingly - as well as telling me on point of entry that my local PCT does not fund surgical reversal. After 60 years of evolution, the transitional pathway has been structured to root out unsuitable patients at various stages. The initial local assessment screens for people who are not appropriate for GIC referral – those, perhaps, who may have confused their discomfort with gender expectations for what is often called (perhaps unhelpfully, given the psychiatrists' aim to separate these from a patient's sex) gender dysphoria – that is, a transsexual impulse.

Nowadays, the GICs – at least 'Charing Cross' (that is, West London Mental Health Trust) – do not police gender presentations as rigorously as in the past, aiming instead to explore and manage their patients' expectations of life in their target bodies. This is slowly becoming more widely understood by transsexual people, but I've still heard voices at community meetings expressing concerns about how openly worries can be explored within the GIC system for fear of jeopardising treatment. This means that not only can people spend long periods between appointments internalising their anxieties, but – more troublingly – feel they cannot discuss them in confidence with a qualified professional.

I've been fortunate enough not to experience any real doubts or regrets so far, partly because I spent years before transition working out that considering myself fundamentally female whilst remaining in a male body was not psychologically tenable, long-term. Counselling dealt well with other mental health concerns, but did not quell my bodily issues – conversely, it brought them to the fore.

Just as importantly, I have found that everyone I care about has provided strong support, and as a consequence, no important ties have been cut. Very few transsexual people are so lucky, for whatever reason, and some who later regret transition do so because parents, children, partners or colleagues remain unable to accept their identities, and the pain of this rejection ultimately overshadows the positive emotions felt on coming out. (This long, sad story about LA Times writer Mike Penner/Christine Daniels illustrates this point.)

Personally, I've not known anyone to detransition: this is not to deny that there are people who genuinely regret transition and particularly surgery purely because they've ended up with a body that wasn't right for them, but instances do seem rare – partly because the pathway allows people to opt out at any point, and some remain on hormones before surgery for much longer than strictly necessary whilst they consider their options.

It's hard to find any definitive study on how many transsexual people regret surgery (who is asked, and why?), but this report from 2009 quotes more than one survey which found satisfaction rates to be over 95%, and points out that some of that small minority regretted poor outcomes rather than the surgery per se. It's worth remembering that people who regret transition are more likely to speak publicly about this than those who do not. They present more of a story to media outlets looking for 'unusual' subjects - especially if those outlets have their own agenda - than either satisfied transsexual people, or those who did not pursue transition and wish they had.

The transitional pathway still relies heavily on psychiatry, which, for all its advances over the years, is not an exact science, but no other 'cure' had been found for genuine and professionally verified cases of gender dysphoria since its first treatment during the 1930s. For the majority of transsexual people, the current solution, for all its imperfections, remains the best one, and as the medical services continue to improve their understanding of the people who present to them, cases of regret should become even rarer.